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Individual

MRS. KIMBERLY RENEE' CARROLL-BEVLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA

Contact information

Practice address
3120 WYOMING ST, SAINT LOUIS, MO 63118-2130
(313) 297-6141
Mailing address
3120 WYOMING ST, SAINT LOUIS, MO 63118-2130
(314) 297-6141

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
253Z00000X
In Home Supportive Care Agency
Primary

Other

Enumeration date
09/17/2020
Last updated
09/17/2020
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